Treatment of Syringoma Using an Ablative 10,600-nm Carbon Dioxide Fractional Laser: A Prospective Analysis of 35 Patients

BACKGROUND Treatment of syringoma aims to destroy the dermal tumor using methods that can include surgical excision, electrodessication, cryosurgery, chemical peeling, and laser ablation, but complete removal of syringomas is often unsuccessful, and recurrence occurs frequently. OBJECTIVE To investigate the therapeutic efficacy of an ablative 10,600-nm carbon dioxide fractional laser system (CO2 FS) for the treatment of periorbital syringomas. METHODS Thirty-five patients with periorbital syringomas were treated with two sessions of CO2 FS at 1-month intervals. Laser fluences were delivered in two or three passes over the lower eyelids, using a pulse energy of 100 mJ and a density of 100 spots/cm(2). Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs and patient satisfaction rates. We examined the histological features of human periorbital syringomas treated with CO2 FS. RESULTS Evaluation of clinical results 2 months after treatment showed that 15 of the 35 patients (42.9%) demonstrated marked (51-75%) clinical improvement, 12 (34.3%) had moderate (26-50%) clinical improvement, five (14.3%) showed minimal (0-25%) improvement, and three (8.6%) showed near total (>= 75%) improvement. Clinical improvement scores were less 4 months after the second CO2 FS treatment (not statistically significant). The mean maximal depth of the necrotic column was 1,236.3 mu m. A specimen obtained from the infraorbital area immediately after treatment showed formation of necrotic columns on the interfollicular skin. CONCLUSION The use of CO2 FS can have a positive therapeutic effect on periorbital syringomas.